Trauma Patient Mortality at a Level I Trauma Center: Is the Tiered Trauma System Effective at Minimizing Mortality?

This thesis contains two clinical research studies carried out on the topic of trauma patient mortality at a Level I trauma center. Both studies are examining the question of: Do trauma patients that are transferred to a Level I trauma center from a lower level trauma center have worse outcomes compared to patients brought directly from the scene of their injury to a Level I trauma center? Each study is accompanied by an abstract briefly summarizing the key points of the individual study. The first study is a systematic literature review of the current evidence on the topic using studies based in North America. The study was conducted using several electronic medical literature databases. The second study is a retrospective cohort study using the University of North Carolina Hospitals Trauma Registry database. This study was carried out using data from over 11,000 patients over a 10-year period, looking at the outcomes of mortality, intensive care unit and hospital length of stay compared by transfer status.Master of Public Healt